Lancet Commission flags concern over surge in tuberculosis deaths

“Progress towards ending tuberculosis has been minimal in some countries and substantial in others. Especially for the highest burden countries, the biggest challenge to ending tuberculosis has been insufficient case finding and diagnosis,” Dr Soumya Swaminathan, Commission co-author and former WHO chief scientist, said.

The report comes at a time when a United Nations High Level Meeting on TB will be held on September 22 and makes a strong case for focusing on a new menu of tools that according to Dr Eric Goosby, Commission co-Chair, UCSF Professor of Medicine and former UN Special Envoy on Tuberculosis, `has the potential to revolutionise TB prevention, diagnosis and treatment.

This new report is a follow-up to the 2019 Lancet Commission on tuberculosis. The first report outlined a blueprint for reaching the goals set by the first UN HLM in 2018. While progress has been made in some areas, the targets of the UN HLM have not yet been achieved. As Covid-19 erased years of reduction in TB mortality rates, the Commission authors in their review, ‘Scientific advances and the end of tuberculosis’, have said that there has been an increase in TB deaths — rising from 1.4 million in 2019 to 1.6 million in 2021. The Commission has also made a series of recommendations including immediate scale-up in access to molecular diagnostics and AI-assisted chest x-ray technology. There is also a strong pitch for newer shorter 1/4/6 treatment regimens.

When contacted, Dr Swaminathan said, “The newer, shorter 1/4/6 TB treatment regimens can have a huge impact on adherence and efficacy. This recommendation would ensure access to one-month regimen or once-weekly for TB prevention, four months for drug-sensitive TB, and six months treatment regimen for drug-resistant TB. To maximise the impact of these significant treatment breakthroughs, we need more countries adopting the new treatment paths faster.”

Adjunct therapies like nutritional support can also go a long way in reducing deaths due to TB, Dr Swaminathan added and said that recent research illustrates the positive impact of giving food baskets to patients with TB and their closest contacts.

In a large study in India, better nutrition in patients with TB reduced incidence of infection by nearly 50% while reducing mortality among those treated for TB by nearly 60%.